<html>
<head>
<title>OUM: Customer Service Survey Form</title>
</head>
<body>
 


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Msgbox("Rating is "&((a+b+c+d+e+f+g+h+j+k)*2)&"%")
Msgbox("Thank you for your survey")	
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</script>
 
<table align="center">
  <tr>
	<td align="center"><img src="logo.gif"></td>
  </tr>
  <tr>
    	<th align="center" border=1 bgcolor='#0000FF'><br><big>Customer Service Survey Form</big></th>
  </tr
  ><tr>
    	<th align="left" bgcolor='#FACC2E'>A. Background</th>
  </tr>
  <tr>
    	<td>
      	<form name="form1" method="post">1. Gender : 
        <input type="radio" name="gender" value="male">Male
        <input type="radio" name="gender" value="female">Female
	<p>2. Race :
          <input type="radio" name="race" value="malay">Malay
          <input type="radio" name="race" value="chinese">Chinese
          <input type="radio" name="race" value="indian">Indian
          <input type="radio" name="race" value="other">Others:
          <input name="others" type="text"/>
      	</p>    
      	<p>3. Nationality :
          <input type="radio" name="national" value="malaysian">Malaysian
          <input type="radio" name="national" value="nomalaysian">Non-Malaysian:
          <input name="nomalaysiant" type="text"/>
      	</p>
      	<p>4. Faculty/Programme :
          <input name="programmefac" type="text"/>
      	</p>

<table>
  <tr>
        <td>5. Programme of Study :</td>
	<td><input type="radio" name="programme" value="diploma">Diploma:  <input name="diplomat" type="text"/></td>
  </tr>
  <tr>
        <td></td>
	<td><input type="radio" name="programme" value="bachelor">Bachelor: <input name="bachelort" type="text" /></td>
  </tr>
  <tr>
        <td></td>
	<td><input type="radio" name="programme" value="posOther">Others [Please State]: <input name="posOthert" type="text"/></td>
  </tr>
  <tr>
	<td>6. Admission session (e.g: 2009/2010) :</td>      
        <td><input name="admission" type="text" /></td>
  </tr>
</table>
<table>  
  <tr>
    	<th align="left" bgcolor='#FACC2E'>B. Please response according to the following scale 1- 5:</th>
  </tr>
  <tr>
	<td>1-Strongly disagree     2- Disagree    3- Not sure   4- Agree   5-Strongly Agree</td>
  
</table>
<table border="1" cellspacing="0" bordercolor="#000000" bgcolor='#81BEF7'>
  <tr>
	<td >Why are you studying at Open University Malaysia (OUM)?</td>
	<td>1</td>
	<td>2</td>
	<td>3</td>
	<td>4</td>
	<td>5</td>
  </tr>
  <tr>
        <td>7. OUM is strategically located and easily accessible.</td>
	<td><input name="s7" type="radio" value="1"></td>
	<td><input name="s7" type="radio" value="2"></td>
	<td><input name="s7" type="radio" value="3"></td>
	<td><input name="s7" type="radio" value="4"></td>
	<td><input name="s7" type="radio" value="5"></td>
  </tr>
  <tr>
        <td>8. OUM has a good reputation among other colleges and higher institutions. </td>
	<td><input name="s8" type="radio" value="1"></td>
	<td><input name="s8" type="radio" value="2"></td>
	<td><input name="s8" type="radio" value="3"></td>
	<td><input name="s8" type="radio" value="4"></td>
	<td><input name="s8" type="radio" value="5"></td>
  </tr>
  <tr>
        <td>9. The cost and programme fees are reasonable. </td>
	<td><input name="s9" type="radio" value="1"></td>
	<td><input name="s9" type="radio" value="2"></td>
	<td><input name="s9" type="radio" value="3"></td>
	<td><input name="s9" type="radio" value="4"></td>
	<td><input name="s9" type="radio" value="5"></td>
  </tr>
  <tr>
        <td>10. The programmes offered by OUM have met the expected job market needs.</td>
	<td><input name="s10" type="radio" value="1"></td>
	<td><input name="s10" type="radio" value="2"></td>
	<td><input name="s10" type="radio" value="3"></td>
	<td><input name="s10" type="radio" value="4"></td>
	<td><input name="s10" type="radio" value="5"></td>
  </tr>
  <tr>
        <td>11. The teaching and learning (T&L) is well supported by the latest technology such as LCD projectors, 
	E-Learning and the like.</td>
	<td><input name="s11" type="radio" value="1"></td>
	<td><input name="s11" type="radio" value="2"></td>
	<td><input name="s11" type="radio" value="3"></td>
	<td><input name="s11" type="radio" value="4"></td>
	<td><input name="s11" type="radio" value="5"></td>
  </tr>
  <tr>
        <td>12. The T&L facilities in OUM  such as lecture rooms and examination halls are in good condition and comfortable.</td>
	<td><input name="s12" type="radio" value="1"></td>
	<td><input name="s12" type="radio" value="2"></td>
	<td><input name="s12" type="radio" value="3"></td>
	<td><input name="s12" type="radio" value="4"></td>
	<td><input name="s12" type="radio" value="5"></td>
  </tr>
  <tr>
        <td>13. The overall T&L environment is conducive.</td>
	<td><input name="s13" type="radio" value="1"></td>
	<td><input name="s13" type="radio" value="2"></td>
	<td><input name="s13" type="radio" value="3"></td>
	<td><input name="s13" type="radio" value="4"></td>
	<td><input name="s13" type="radio" value="5"></td>
  </tr>
  <tr>
        <td>14. The computer labs are well equipped and up-to-date. </td>
	<td><input name="s14" type="radio" value="1"></td>
	<td><input name="s14" type="radio" value="2"></td>
	<td><input name="s14" type="radio" value="3"></td>
	<td><input name="s14" type="radio" value="4"></td>
	<td><input name="s14" type="radio" value="5"></td>
  </tr>
  <tr>
        <td>15. The coverage for wireless internet access is good and reliable. </td>
	<td><input name="s15" type="radio" value="1"></td>
	<td><input name="s15" type="radio" value="2"></td>
	<td><input name="s15" type="radio" value="3"></td>
	<td><input name="s15" type="radio" value="4"></td>
	<td><input name="s15" type="radio" value="5"></td>
  </tr>
  <tr>
        <td>16. Overall academic services and administration are satisfactory.</td>
	<td><input name="s16" type="radio" value="1"></td>
	<td><input name="s16" type="radio" value="2"></td>
	<td><input name="s16" type="radio" value="3"></td>
	<td><input name="s16" type="radio" value="4"></td>
	<td><input name="s16" type="radio" value="5"></td>
  </tr>
</table><p>Your comments and suggestions will be useful for leveraging the quality of academic service and management.</p>
        <p>
      <input name="onsubmit" type="button" value="Submit" >
      <input name="reset" type="reset" value="Reset!">    
      </form>
    </td>
  </tr>
</table>
</body>
</html>
